Baby Beat: Deciding the fate of unused embryos

Tuesday

Mar 5, 2013 at 4:00 AM

By Dr. Gary Benfield Special to The Review

Hundreds of thousands of frozen embryos have accumulated in fertility clinics throughout this country. Some await transfer, but most are literally frozen in time as couples ask themselves -- over and over -- "What's the best thing to do with our unused embryos?"

In a survey of 58 couples, researchers from the University of California in San Francisco found that 72 percent were undecided about the fate of their stored embryos. In another study of more than 1,000 fertility patients from nine clinics, 20 percent of couples who did not want more children said they expected to keep their remaining embryos frozen indefinitely. Some couples have kept their frozen embryos for five years or more, waiting for inspiration that never comes. Then when the storage fee comes due, couples generally have four choices:

1. Donating to medical research. One couple had five embryos left and spent more than a year weighing their choices against their religious beliefs. They finally decided to donate the embryos for medical research, as a gesture of gratitude to a system that had given them their dreams.

Many couples find donating to research a middle ground that gives their embryos a status somewhere between born children and a simple clump of cells. Although the embryos will not survive, giving to science can be a very caring act. Couples who donate to research feel like they were helped by science and they want to give back.

2. Donating to other infertile couples. The first thing many couples want, once they have finished forming their own families, is to let another infertile couple have the embryos. On the face of it, it's a truly altruistic and beautiful gesture. But donating your embryos can be an emotional process, and depending on the state you live in and your clinic, it can be legally difficult as well. The process may be as simple as filling out paperwork or as involved as hiring an attorney to navigate a complex legal process and locate a recipient family.

3. Thawing without donating. Here's where things can get a little strange. A few women have found a doctor willing to perform a "compassionate transfer," implanting the embryos into the woman at a time when pregnancy is unlikely. They see this as a way to return the embryos to their keeping rather than simple allowing them to thaw and die. Other couples choose to perform a ceremony of some sort during the thawing and disposal to show their respect.

Some couples who want other choices besides thawing discover they have none. One woman was hoping to donate her three embryos to science after she had their children through in vitro fertilization. But her clinic said that wasn't an option. She wishes now that she had asked about the issue before choosing a physician. So she paid for another year of storage; it was too hard to let go at that moment. But, eventually, she did and grieved for her loss.

4. Postponing the decision. Many couples simply can't decide. So they continue paying storage costs, year after year. Meanwhile, parents die. Marriages end. People move and forget to tell the clinic, leaving fertility clinic staff with unpaid bills and their own difficult choice. One couple, after filing for divorce, fought a legal battle for more than five years over custody of their frozen embryos. She wanted them implanted in herself so that she could have a baby; he wanted them destroyed. In 2008, the woman lost the case.

In another case, a woman had one embryo left after giving birth to her children, ages seven and six. Finally, after debating what to do for two more years, she and her husband decided to have another baby, now a 3-year-old daughter. "One unused embryo changed my whole life," she said. She's thankful for her daughter, but also thankful she had only one embryo remaining.

A further thought: Less than two months after taking office in 2008, President Barack Obama lifted restrictions on federal funding for stem cell research, reversing a policy that had put a damper on using surplus embryos for scientific purposes. As a result, more parents may be able to donate unused embryos for research in the future.

By the way, the cost of storing one or more frozen embryos seems to range from $300 to $1,200 per year, with storage facilities in New Jersey among those charging the highest rates.